Heart burn or heart attack?

Dr. Lubin F. Arevalo

The holiday season means friends, family and good cheer, usually taking place around the dinner table. A big meal may cause heartburn, or aggravate chronic acid reflux, but sometimes the symptoms aren’t what you’d expect.

“Some people suffer from chest pain that they describe as comparable to a heart attack,” said Dr. Lubin F. Arevalo, assistant professor of medicine – gastroenterology. “Although chest pain can be potentially caused by reflux disease, it is important to see a doctor right away to rule out a heart attack as well as learn about your heart attack risk factors. We never embark on a search for reflux as a cause of chest pain until a thorough cardiac evaluation shows us that the pain is not coming from the heart.”

Symptoms of reflux disease include heartburn (a burning feeling in the chest or throat), regurgitation (the sensation that stomach fluids are backing up into the throat), difficulty swallowing and chest pain. Some patients may present with less typical symptoms such as cough, Arevalo said.

“Once we know the pain is not caused by heart issues, it is time to see a gastroenterologist who can help make a diagnosis and determine the right line of treatment,” he said.

Some treatment options include lifestyle changes like weight loss, quitting smoking, ending late night snacking and avoiding food triggers such as fried food. There are also medications that can be prescribed to decrease or neutralize stomach acid.

“If reflux disease is untreated it could lead to complications. In the worst cases that includes esophageal cancer,” Arevalo said.

Seeing a doctor is also important for patients whose condition does not improve with these treatments. They may have uncontrolled reflux or in some cases they may have a different problem that can cause symptoms that are similar to reflux. These patients often benefit from additional testing using reflux monitoring studies.

“Bottom line, talk to your doctor. For chest pain that is not coming from the heart, reflux is an important possible explanation and establishing the cause will help find a solution,” Arevalo said.